Document level: Trustwide Code: CP71 Issue number: 1 Administration of urinary catheter maintenance solution by a carer Lead executive Director of Nursing Therapies Patient Partnership Authors details Kenneth Henderson, Community Urology Lead Nurse -0151 347 4217 Type of document Target audience Document purpose Guidance All clinical staff To enable a carer of a named patient to safely administer prescribed urinary catheter maintenance solutions by achieving agreed competencies supervised and maintained by a Community Care Team (CCT). Approving meeting Quality Governance & Effectiveness Meeting Date 17.06.2016 Implementation date 01.09.2016 followed by an annual compliance review CWP documents to be read in conjunction with CC4 Clinical Guideline for the Use of a Catheter Maintenance Solution IC3 Standard Universal Infection Control Precaution Policy Document change history What is different? Appendices / electronic forms What is the impact of change? Training requirements N/A Have appendices been added, or changed since the last issue, if so explain the reasons why? N/A Impact on how urinary catheter maintenance solutions are administered on a selected named patient named carer basis Training requirements for this guidance are in accordance with the CWP Training Needs Analysis (TNA) with Learning and Development (L&D) Document consultation East locality Who within this service have you spoken to Wirral locality Who within this service have you spoken to West locality Who within this service have you spoken to Corporate services Who within this service have you spoken to External agencies Who within this service have you spoken to Financial resource implications N/A External references LINC Medical Systems Ltd Bladder Infusion Kit - accessed at http://www.linc-medical.co.uk/product/index/id/342/cat/18 Page 1 of 6 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
Equality Impact Assessment (EIA) - Initial assessment Yes/No Comments Does this document affect one group less or more favourably than another on the basis of: - Race No - Ethnic origins (including gypsies and travellers) No - Nationality No - Gender No - Culture No - Religion or belief No - Sexual orientation including lesbian, gay and bisexual people No - Age No - Disability - learning disabilities, physical disability, sensory impairment and mental health problems No Is there any evidence that some groups are affected differently? No If you have identified potential discrimination, are there any exceptions valid, legal and/or justifiable? Select Is the impact of the document likely to be negative? No - If so can the impact be avoided? - What alternatives are there to achieving the document without the impact? - Can we reduce the impact by taking different action? Where an adverse or negative impact on equality group(s) has been identified during the initial screening process a full EIA assessment should be conducted. If you have identified a potential discriminatory impact of this procedural document, please refer it to the human resource department together with any suggestions as to the action required to avoid / reduce this impact. For advice in respect of answering the above questions, please contact the human resource department. Was a full impact assessment required? No What is the level of impact? N/A To view the documents Equality Impact Assessment (EIA) and see who the document was consulted with during the review please click here Page 2 of 6 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
ADMINISTRATION OF URINARY CATHETER MAINTENANCE SOLUTION BY A CARER A carer can be a paid carer from a Care Agency or a designated family member appointed by a patient. Paid carers from a Care Agency must complete all competencies. A family carer should attempt to complete all competencies. Prior to the administration of prescribed urinary catheter maintenance solutions an initial assessment must be completed by a registered nurse competent in administering urinary catheter maintenance solutions. Once an assessment has been completed and the urinary catheter maintenance solutions have been prescribed as part of urinary catheter management the task can be delegated to a carer. It is the Community Care Teams (CCT) responsibility to ensure a review of the carer skills is undertaken on a 3 monthly basis. A competency assessment is required to ensure carers who are delegated the task are competent to administer urinary catheter maintenance solutions to a named patient: Training must have been undertaken on a named patient named carer basis as part of the individual patients urinary catheter management. All named carers must receive the appropriate training and be deemed confident and competent under supervised practice before undertaking this procedure Every carer should be re assessed every 3 months by the Community Care Team Contact details of the relevant Community Care Team must be given to the patient and carer. Carers who are employed by a Care Agency must provide evidence of employers indemnity insurance prior to undertaking the procedure Page 3 of 6 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
Competency document Administration of urinary catheter maintenance solution by named carer In order to complete this document the carer will need to undertake a minimum of 3 supervised practices or until the carer feels confident and competent to carry out the procedure. It is the carers responsibility to maintain skills and knowledge and to report any limitations in knowledge or skills to the patients Community Care Team for further training & support. Patient name Address D.O.B & NHS Number Name of carer & employing agency Name & Designation of Assessor The carer must demonstrate competencies in the following procedures Date Initial Date Initial Date Initial Prior to undertaking the procedure the carer should ask the patient if they have are experiencing any of the following Any concerns about the procedure Discomfort or burning sensation in or around the urinary catheter insertion site Constipation Visible blood in the urine drainage bag If the answer to any of these is YES the procedure SHOULD NOT be undertaken and further advice must be sought from the relevant Community Care Team (CCT). Explain procedure and gain informed consent from the patient Ensure working area is free of clutter or obstruction Ensure patient is lying down on their back and comfortable Cover the patient to maintain dignity Page 4 of 6 Do not retain a paper version of this document, always view from the website www.cwp.nhs.uk to ensure it is the correct version
Wash hands with soap and water or decontaminate hands using alcohol based hand gel put on an apron and non-sterile gloves as per infection control guidelines Empty leg or night bag Remove gloves Wash hands with soap and water or decontaminate hands using alcohol based hand gel and put on disposable non sterile gloves as per infection control guidelines Remove the outer packaging from the catheter maintenance solution If the LINC Bladder Infusion Kit is being used remove outer packaging The LINC Medical Bladder Infusion Kit is only recommended for patients who require 2 or more bladder instillations per week Wipe the drainage bag needle free port with an alcohol based wipe by wiping once across the surface of the needle free port Place LINC Bladder Infusion Kit clamp on drainage bag tubing just below the drainage bag needle free port Remove protective cap from the catheter maintenance solution and insert nozzle into the LINC Bladder Instillation Kit adapter Insert the LINC Bladder Infusion Kit nozzle into the drainage bag needle free port and administer solution as prescribed following manufacturers instructions Know when to abandon procedure & report to Community Care Team (CCT) e.g. If patient complains of pain on administration of the catheter maintenance solution or if any difficulties administering the catheter maintenance solution are experienced Remove LINC Bladder Infusion Kit attached to catheter maintenance solution from drainage bag needle free port while holding catheter Unclip LINC Bladder Infusion Kit clamp from the drainage bag tubing and observe for urine drainage. If blood is seen in urine drained or if urine is not draining contact the Community Care Team (CCT) for advice. Page 5 of 6 Do not retain a paper version of this document, always view from the website www.cwp.nhs.uk to ensure it is the correct version
If the LINC Bladder Infusion Kit is not being used; Before administration of the catheter maintenance solution disconnect the urine drainage bag from the catheter and administer solution as prescribed following manufacturers instructions. Attach a new drainage bag to the catheter and observe for urine drainage. If blood is seen in urine drained or if urine is not draining contact the appropriate Community Care Team (CCT) for advice. For all patients Ensure drainage bag is secured with appropriate straps/leg bag holder Dispose of waste appropriately in a closed/sealed bag Ensure patient is comfortable Record the following information in the patient records; Batch number and expiry date of catheter maintenance solution amount of solution instilled into the bladder report the colour of urine drained and note if there is any debris or blood seen in drainage bag. Report any complications. Agreement of care plan (Signatures of Patient and Health professional) Patient Registered General Nurse.. Date signed. Date signed A Registered General Nurse from a Community Care Team (CCT) must arrange to check the above competencies on a 3 monthly basis or at the request of the carer or patient if there are any concerns Page 6 of 6 Do not retain a paper version of this document, always view from the website www.cwp.nhs.uk to ensure it is the correct version